99 



in the capillar}- lumen, none being seen inside the cells. The 

 parench3'ma cells in the neighborhood of these bacterial emboli 

 show evidence of necrobiosis (poorly stained nuclei, etc.). The 

 pulmonary tissue exliibits alveoli partly filled with desquamated, 

 pigment-containing alveolar epithelia, and granular material, while 

 here and there ma}' be seen an air space almost completely filled 

 with blood. The interalveolar capillaries and the other pulmonary 

 blood vessels are much congested and densely filled with blood. 

 Quite a few plague bacilli are found in the interalveolar con- 

 nective tissue. It appears that these organisms are located inside 

 the epithelial cells lining the l}Tnph clefts, some also being found 

 inside the alveolar epithelia. Xone are found in the pulmonary 

 blood vessels. The alveoli show the presence of a small number 

 of large, slender bacilli, which, like the organisms of plague, are 

 decolorized by Gram's method. 



Case No. 15. Right Axillary BtrBo. 



[Necropsy Protocol No. 973. F. A., Filipino, male, age 28 years, from 661 Calle 

 Bllibid, Santa Cruz ; died May 9, 1904, at 11 o'clock p. m. Post-mortem exam- 

 ination made fifteen hours after death.] 



The body of a strong, well-developed man between 25 and 30 

 years of age. Nutrition is good. Post-mortem rigidity is marked ; 

 post-mortem lividity is well developed. Near the right nipple 

 there are seen two dried-up vesicles, which are completely collapsed 

 and covered with dry epidermal scales. Otherwise there are no 

 open wounds on the body. The right axillar}^ lymphatics form a 

 flat doughy mass of the size of the palm of the hand. The swelling 

 in the right axillar}' space is not well defined but gradually shades 

 off into the surrounding tissue; the skin overlying this region is 

 very cyanotic. On being cut the mass is found to be very cedematous 

 and it first discharges a blood-tinged serum and then a bloody 

 fluid. Xo individual glands can be mapped out, but everything is 

 completely infiltrated by a hemorrhagic exudate. The latter is 

 continued into the deep fascia of the thorax and the pectoral 

 muscles, finally reaching the intercostal muscles and penetrating 

 into the thorax. The inguinal, cervical, and cubital glands are all to 

 a certain extent palpable, and, when dissected out, are found to be 

 somewhat enlarged, softened, and congested. On opening the 

 body cavities the serous membranes are seen to be congested and 

 rather dull. The serous fluid in the abdominal and thoracic 

 cavities is not increased. The right lung has formed a few slight 



